Perceptions of Maine Health Care Providers on Youth Tobacco Use and Prevention Efforts

Abstract

Introduction: Tobacco use causes preventable morbidity and mortality, and leads to high medical costs annually. In Maine, both cigarette and electronic cigarette (e-cigarette) use among high school students are higher than the national average. To what extent Maine health care providers are familiar with tobacco use prevention is unknown. We aimed to describe the knowledge, attitudes, and practices of Maine health care providers regarding youth tobacco use. We also determined what preventive services they provide, and measured their self-efficacy regarding screening and counseling for tobacco use. Methods: In this cross-sectional study, health care providers were surveyed about their knowledge, attitudes, and measured their self-efficacy and practices related to youth tobacco use. Logistic regression modeling and chi-square tests were used to determine associations between variables. Results: Providers with at least 10 years of experience had more self-efficacy to discuss cigarettes (OR, 3.4; 95% CI, 1.6 - 7.4; P = .002) and chewing tobacco (OR, 3.1; 95% CI, 1.5 - 6.8; P = .003), but not e-cigarettes (OR, 1.2; 95% CI, 0.6 - 2.5; P = .6), with their patients. However, neither self-efficacy nor familiarity with prevention resources and policies impacted screening practices. Discussion: Knowledge alone is not sufficient to cause behavioral change. However, the high self-efficacy expressed by providers indicates their willingness to adopt changes to their clinical practices, given adequate training. Conclusions: There are knowledge and practice gaps in tobacco prevention efforts. Training health care providers and implementing tobacco screening practices will improve the quality of health services offered to Maine youth at clinic visits.